Overwhelming panic

[everyman833]

Each morning I awaken with a racing heart, and it does not abate, even with the use of anti-anxiety drugs. I have tried Paxil, Celexa, Remeron, and Zoloft, all of which I could not tolerate due to side effects. My psychiatrist recommended the addition of neurontin to the Xanax to help boost its effects, but I ended up sleeping the entire day instead. I know I need to find a medication that works, but am so discouraged and frightened because I have not been successful so far, and am getting worse. The strange thing is, every evening, the symptoms subside, and I begin to feel calm and "normal" again. My heart rate returns to normal and I begin to feel more like myself. I feel like if I could just control this anxiety and panic, I could cope, but it takes such a high dose of anything to allay the symptoms, I am still unable to function. I have been hospitalized before for similar symptoms, but not for many years. I fear losing control, and fear having suicidal thoughts out of desperation. In no way do I want to die, I just want to feel better. I am at my wits end, and don't know what to do next.
Please help with your suggestions in regards to medication. Am I correct in that the panic/anxiety is depression driven? And why does it follow this pattern? Panic in morning, calm in evening?
Thank you.

[Roger Gould, M.D.]

I think you should continue to explore your very important observation about the pattern of your anxiety. I will give you one probability but you may have to either dig deeper or pursue this further.  That pattern can be  read as facing the day scares you while no longer having to face the day relieves you. The question is what frightens you? MOst of the time it is a decision about making a change in your life or facing a challenge or having to adapt and grow.  That is what you and your psychiatrist should explore.

Regarding medications, ask your doctor about the combination of a low dose antidepressant you haven't yet tried like Zoloft and Klonopin instead of Xanax.  That may help.

[wozza]

Hi I’m 31 years old and have exactly the same problem. It just started about 2 years ago without any notice. I was reading book in bed (no nothing saucy just a computer manual.. yes sadly) and I felt want I think was a palpitation for the first time. I thought I was about to have a heart attack. I jumped out of bed in complete and utter panic and just wanted to get out of the house into open air...weird. Anyhow from that day on I have suffered from panic attacks just as you and the other describe on this thread. The feeling that im about to die....listening to every beat of my heart, dizziness, even shaking. It would happen mostly at night were I would lie in bed listening to my heart. It also happened once when I was on the underground rail here in London in rush hour. I felt like I if I were to have a heart attack that nobody would help. After 30mins journey home I could feel my heart racing and ended up going to hospital emergency were ECG was done without any problems...after 1hr I was normal again. I initially felt very alone with no real explanation of what was going on. Looking at medical books I convinced myself that I had everything from cancer to heart failure based on my symptoms. I ended up wearing a monitor which recorded my heart over a 24 hr period, which when analysed by the doctor came up negative on any heart problems. The doctor did say I should start exercising so I started going to the gym and doing a lot of aerobic exercise for about an hour a night. I have purchased a heart rate monitor to keep within required training beats per minute zone. I have found that the panic attacks have just about disappeared and when they do come I know its not my heart cos if it was it would have certainly showed up at the gym were I try maintain a constant heart rate of 165-170 bpm. I still have these panic attacks but they are probably once a month or so from almost once a day in the early days. I hope my story makes you feel at ease just as the other ones should as well. As somebody said "they come and go" and just remember in the past when it happened you always came through no matter how bad it feels at the moment!!!!

Try the gym/exercise suggestion....it truly has worked for me!!

Regards

wozza